Systemic racism moderates effects of provider racial biases on adherence to hypertension treatment for African Americans.

Greer, Tawanda M.; Brondolo, Elizabeth; Brown, Porschia

doi:10.1037/a0032777

Cited by 47 publications

(27 citation statements)

References 36 publications

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“…One primary confusion found in the literature review was the authors' use of an instrument to measure MM that supports the group-based historical injustices as noted in the Williams and Mohammed framework (e.g., GBMMS) while not describing this viewpoint in the background. 77,78,97,98 Even when the authors use a reliable and valid MM measure (e.g., GBMMS), they continue to interchanged interpersonal trust and MM 99 in the description of the concept, the analysis, and the discussion of the findings. Despite our purposeful exclusion of studies that focused on or measured "trust" in health care, some studies that were included inaccurately defined MM as "low trust in a provider or system" or used a measure of "system mistrust" (the MMI) to evaluate "interpersonal mistrust."…”

Section: Discussionmentioning

confidence: 99%

“…The remaining 22 studies provided a mixed perspective in the introduction as to the source of the mistrust often relying heavily on bias or discrimination by health care providers without discussing the larger societal structure that may have influenced the providers. For example, Greer and colleagues 78 discussed the link between discrimination and MM in an African American sample, but the literature review emphasizes the importance of the patientprovider relationship and interactions as the source of discrimination.…”

Section: Quantitative Studies Of MMmentioning

confidence: 99%

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Ubiquitous Yet Unclear: A Systematic Review of Medical Mistrust

Benkert

Cuevas

Thompson

et al. 2019

Behavioral Medicine

149

106

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Peer-reviewed articles (n = 124) examining associations between medical mistrust (MM) and health outcomes from four databases, between January 1998 and May 2018, were reviewed; 36 qualitative and 88 quantitative studies met the inclusion criteria. The Williams and Mohammed framework guided our narrative synthesis of the studies; it argues that basic causes (e.g., biased institutions) affect the social status of marginalized groups which in turn effects multiple proximal pathways leading to responses and poor health. Most studies were cross-sectional with US-based samples. The MM in qualitative studies were categorized as interpersonal (n = 30), systemic (n = 22), and/or vicarious (n = 18); 25% did not explicitly note the basic causes of MM and race/ ethnicity was often confounded with socioeconomic status (SES). All but three studies discussed an association between MM and a behavior response; no study focused on an actual health outcome. Most quantitative studies used multivariate regression analyses; only 15 of the 88 utilized advanced modeling techniques (e.g., mediation). Most (75%) studies did not describe basic causes for MM and 43% utilized low income samples. MM was conceptualized as a predictor/proximal pathway (in 73 studies) associated with a variety of responses, most commonly behavioral (e.g., diminished adherence); 14 studies found an association between MM and a specific health measure. This review underscores the need for future qualitative studies to place MM central to their research questions as in-depth descriptions of MM were limited. Future quantitative studies should replicate findings using more advanced analytical strategies that examine the relationship between MM and health outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Quantitative Studies Of MMmentioning

confidence: 99%

Ubiquitous Yet Unclear: A Systematic Review of Medical Mistrust

Benkert

Cuevas

Thompson

et al. 2019

Behavioral Medicine

149

106

View full text Add to dashboard Cite

show abstract

“…The potential for double-edged links from racial identity to health could be further extrapolated by considering connections between racial identity and justice beliefs, which might be similarly divergently linked. Future research might also consider the extent to which justice plays a role in other CVD-relevant health behaviors that may be similarly affected by perceived racism, such as treatment adherence (e.g., Greer, Brondolo, & Brown, 2014). …”

Section: Discussionmentioning

confidence: 99%

A preliminary experimental examination of worldview verification, perceived racism, and stress reactivity in African Americans.

Lucas¹,

Lumley²,

Flack³

et al. 2016

Health Psychology

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Objective According to worldview verification theory, inconsistencies between lived experiences and worldviews are psychologically threatening. These inconsistencies may be key determinants of stress processes that influence cardiovascular health disparities. This preliminary examination considers how experiencing injustice can affect perceived racism and biological stress reactivity among African Americans. Guided by worldview verification theory, it was hypothesized that responses to receiving an unfair outcome would be moderated by fairness of the accompanying decision process, and that this effect would further depend on the consistency of the decision process with preexisting justice beliefs. Method A sample of 118 healthy African American adults completed baseline measures of justice beliefs, followed by a laboratory-based social-evaluative stressor task. Two randomized fairness manipulations were implemented during the task: participants were given either high or low levels of distributive (outcome) and procedural (decision process) justice. Glucocorticoid (cortisol) and inflammatory (C-reactive protein) biological responses were measured in oral fluids, and attributions of racism were also measured. Results The hypothesized 3-way interaction was generally obtained. Among African Americans with a strong belief in justice, perceived racism, cortisol and C-reactive protein responses to low distributive justice were higher when procedural justice was low. Among African Americans with a weak belief in justice however, these responses were higher when a low level of distributive justice was coupled with high procedural justice. Conclusions Biological and psychological processes that contribute to cardiovascular health disparities are affected by consistency between individual-level and contextual justice factors.

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“…6 For instance, distress often manifests as intense emotionality [7][8][9] that affects the experience of negative and positive emotions as well as cognitive and behavioral factors that actually cause, worsen, and prolong the stressful situations that patients struggle to tolerate. One such factor that commonly accompanies this intense emotionality in distress is perseverative negative thinking (PNT; e.g., worry, rumination 10,11 self-criticism, 12 loneliness, 13,14 and perceived discrimination [15][16][17][18][19] ). PNT complicates treatment responsiveness, increases unhealthy habits, 20 and interferes with life-style and treatment engagement.…”

Section: Conceptualizing Mood and Anxiety Difficulties In The Contextmentioning

confidence: 99%

Emotion Regulation Therapy and Its Potential Role in the Treatment of Chronic Stress-Related Pathology Across Disorders

Fresco

Mennin

2020

Chronic Stress

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Although stress is an inevitable part of everyday life, its chronicity, severity, and perceived burden can result in enduring distress, which may manifest as heightened emotionality, contributing to a number of self-regulatory failures. Specifically, distress disorders are characterized, in part, by heightened sensitivity to underlying motivational systems related to threat/ safety, reward/loss, or both. Further, individuals suffering from these conditions typically engage in perseverate negative thinking (e.g., worry, rumination, self-criticism) in an effort to manage motivationally relevant distress and often utilize these processes at the detriment of engaging in new contextual learning. Distress disorders are often brought on by enduring chronic stress, coupled with these maladaptive emotional, cognitive, and behavioral responses and ensuing impairment which contribute to and in turn worsen the deficits from these purported mechanisms. Emotion regulation therapy is a theoretically derived treatment that is based upon affective science to offer a blueprint for improving intervention by focusing on targeting the motivational responses and corresponding regulatory failures of individuals with distress disorders. Open and randomized controlled trials have demonstrated considerable preliminary evidence for the utility of emotion regulation therapy and its proposed mechanisms in treating the distress conditions.

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Systemic racism moderates effects of provider racial biases on adherence to hypertension treatment for African Americans.

Abstract: The overall findings suggest that patients who perceive themselves as infrequently exposed to systemic racism possess the greatest risk for nonadherence to hypertension treatment in relation to increased perceptions of provider racial biases. Implications of the findings are discussed.

Cited by 47 publications

References 36 publications

Ubiquitous Yet Unclear: A Systematic Review of Medical Mistrust

Ubiquitous Yet Unclear: A Systematic Review of Medical Mistrust

A preliminary experimental examination of worldview verification, perceived racism, and stress reactivity in African Americans.

Emotion Regulation Therapy and Its Potential Role in the Treatment of Chronic Stress-Related Pathology Across Disorders

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